Rumination is the compulsively focused attention on the symptoms of one's distress, and on
its possible causes and consequences, as opposed to its solutions. Rumination is similar to
worry except rumination focuses on bad feelings and experiences from the past, whereas worry
is concerned with potential bad events in the future. Both rumination and worry are
associated with anxiety and other negative emotional states.
Rumination has been widely studied as a cognitive vulnerability factor to depression, however
its measures have not been unified. In the Response Styles Theory proposed by Nolen-Hoeksema,
rumination is defined as the “compulsively focused attention on the symptoms of one's
distress, and on its possible causes and consequences, as opposed to its solutions”. Because the
Response Styles Theory has been empirically supported, this model of rumination is the
most widely used conceptualization. Other theories, however, have proposed different
definitions for rumination. For example, in the Goal Progress Theory, rumination is conceptualized
not as a reaction to a mood state, but as a “response to failure to progress satisfactorily
towards a goal”. This article introduces several models of
rumination and aims to distinguish rumination from other constructs that may appear similar
or overlap with rumination conceptually.
Theories Response styles theory
Response styles theory initially defined rumination as passively and repetitively focusing on
one's symptoms of depression and the possible causes and consequences of these symptoms.
As evidence for this definition, rumination has been implicated in the development, maintenance,
and aggravation of both depressive symptoms as well as episodes of major depression. Recently,
RST has expanded the definition of rumination beyond depression to include passive and repetitive
focus on symptoms of distress in general. This change was made because rumination has
been implicated in a host of disorders, not just depression.
RST also contends that positive distraction is the healthy alternative to rumination,
where focus is directed to positive stimuli instead of to distress. However, the literature
suggests that positive distraction may not be as potent a tool as once thought.
Self-regulatory executive function model The self-regulatory executive function model
of affective dysfunction contends that rumination can be explained most precisely within a multilevel
model of self-regulation. Specifically, the S-REF model defines rumination as "repetitive
thoughts generated by attempts to cope with self-discrepancy that are directed primarily
toward processing the content of self-referent information and not toward immediate goal-directed
action." Put more simply, when a person ruminates, he or she aims to answer questions such as:
How do I feel about this event? How can I change my thoughts and feelings
about the event? How can I prevent disturbing thoughts and
feelings in the future? However, in answering these questions, ruminators
tend to focus on their emotions as opposed to problem solving.
Metacognition is also an important part of the S-REF model and helps to explain the link
between rumination and depression. Specifically, those who hold positive metacognitive beliefs
about the benefits of rumination are probably motivated to engage perseveratively in rumination.
Once engagement in rumination has occurred, individuals' negative metacognitive beliefs
about rumination are likely to be activated, seeing it as unpleasant, uncontrollable, and
socially damaging. These negative metacognitive beliefs then contribute to the development
and maintenance of depression. Goal progress theory
Goal progress theory seeks to explain rumination as a function of goal progress. Specifically,
GPT views rumination as an example of the Zeigarnik Effect, which suggests that individuals
are more likely to remember information from unfinished tasks than from finished tasks.
From this understanding, GPT defines rumination as "the tendency to think recurrently about
important, higher order goals that have not yet been attained" or towards which sufficient
progress has not been made. GPT predicts that individuals for whom goal-related
information is highly accessible should be more likely to ruminate. Various studies have
provided support for this prediction. Pathology
Extensive research on the effects of rumination, or the tendency to self-reflect, shows that
the negative form of rumination interferes with people’s ability to focus on problem-solving
and results in dwelling on negative thoughts about past failures. Evidence from studies
suggests that the negative implications of rumination are due to cognitive biases, such
as memory and attentional biases, which predispose ruminators to selectively devote attention
to negative stimuli. The tendency to negatively ruminate is a stable
constant over time and serves as a significant risk factor for clinical depression. Not only
are habitual ruminators more likely to become depressed, but experimental studies have demonstrated
that people who are induced to ruminate experience greater depressed mood. There is also evidence
that rumination is linked to general anxiety, post traumatic stress, binge drinking, eating
disorders, and self-injurious behavior. Rumination was originally believed to predict
the duration of depressive symptoms. In other words, ruminating about problems was presumed
to be a form of memory rehearsal which was believed to actually lengthen the experience
of depression. The evidence now suggests that although rumination contributes to depression,
it is not necessarily correlated with the duration of symptoms.
Types and content of ruminative thoughts Theories of rumination differ in their predictions
regarding the content of ruminative thoughts based on their respective conceptualizations.
Some models propose that rumination is focused on negative feeling states and/or the circumstances
surrounding that emotion. Rumination in other models focuses on discrepancies between one's
current and desired status. Finally, other models propose that it is the negative themes
of uncontrollability and harm in metacognitions that are most important. Some common thoughts
that are characteristic of ruminative responses are questioning the well-being of oneself
and focusing on the possible causes and consequences of their depressive symptoms. For example,
some ruminative thoughts include “why am I such a loser”, “I’m in a such bad
mood” or “I just don’t feel like doing anything”.
Another difference emerged in the content of rumination concerns the time period of
ruminative thinking, with several theories supposing that rumination can vacillate between
past, current, and future focus, and others assuming that ruminative content is focused
on the past or present. It is consistently reported that rumination, in comparison to
worry, contains past-related thoughts. However, a more recent study found that time orientation
changes over the course of rumination, such that individuals begin with a past focus,
but increase in present and future related thoughts over the course of ruminating. Thus,
rumination may be more complicated than previously thought, and not necessarily wholly past focused.
Three forms of rumination have been proposed State rumination, which involves dwelling
on the consequences and feelings associated with the failure. State rumination is more
common in people who are pessimistic, neurotic, and who have negative attributional styles.
Action rumination, which consists of task-oriented thought processes focused on goal-achievement
and correction of mistakes. Task-irrelevant rumination, which utilizes
events or people unassociated with the blocked goal to distract a person from the failure.
Measurement The tendency to ruminate can be assessed with
the Ruminative Responses Scale of the Response Styles Questionnaire. On this measure, people
are asked to indicate how often they engage in 22 ruminative thoughts or behaviors when
they feel sad or blue. Gender differences
According to Susan Nolen-Hoeksema, women tend to ruminate when they are depressed, whereas
men tend to distract themselves. This difference in response style was proposed to explain
the higher rates of depression in women compared to men. Researchers have confirmed the greater
likelihood of rumination in women, though the prediction that men are more likely to
distract themselves has not been consistently supported.
Healthy self-disclosure Although rumination is generally unhealthy
and associated with depression, thinking and talking about one's feelings can be beneficial
under the right conditions. According to Pennebaker, healthy self-disclosure can reduce distress
and rumination when it leads to greater insight and understanding about the source of one's
problems. Thus, when people share their feelings with others in the context of supportive relationships,
they are likely to experience growth. In contrast, when people repetitively ruminate and dwell
on the same problem without making progress, they are likely to experience depression.
Co-rumination is a process defined as “excessively discussing personal problems within a dyadic
relationship”, a construct that is relatively understudied in both its negative and positive
trade-offs. Relationship to other related constructs
Rumination has been confounded with other similar constructs that may overlap with it.
Worry and negative automatic thoughts are two of them.
Worry Rumination appears closely related to worry.
Worry has been identified as “a chain of thoughts and images, negatively affect-laden
and relatively uncontrollable; it represents an attempt to engage in mental problem solving
on an issue whose outcome is uncertain, but contains the possibility of one or more negative
outcomes.” Rumination has also been compared to worry,
and in some models, is considered a type of worry. Many researchers have noted the high
comorbidity of Generalized anxiety disorder and depression; over 60% of clients who present
with symptoms of GAD also qualify for a diagnosis of major depressive disorder. This significant
concurrence has led to an increasing literature on the overlap between rumination, which is
often studied in the context of depression, and worry, which is often studied in the context
of GAD. Measures of rumination and worry have also
demonstrated high correlations, above and beyond that of symptom measures of anxiety
and depression. Rumination and worry overlap in their relationships to anxiety and depression,
although some studies do indicate specificity of rumination to depression and worry to anxiety.
Rumination has been found to predict changes in both depression and anxiety symptoms and
individuals with major depression have been reported to engage in levels of worry similar
to individuals with GAD. As a whole, these studies suggest that rumination and worry
are related not only to each other, but also each is related to symptoms of both depression
and anxiety. Other studies have demonstrated that the content
of worry and rumination are distinct; worry thoughts are often focused on problem-solving
and have a future orientation, whereas ruminative thoughts concern themes of loss and are more
focused on the past. Rumination, as compared to worry, has also been associated with less
effort and less confidence in problem solving. It has also been suggested that rumination
and worry serve different purposes, namely that rumination is associated with greater
belief in the personal relevance of a situation and a larger need to understand it, whereas
worry is associated with a desire to avoid worry thoughts. Worry has also been hypothesized
to contain more imagery than rumination; however, support for this has been mixed.
Overall, these studies suggest that worry and rumination are related constructs that
both lead to depression and anxiety. It is likely that rumination and worry, as with
rumination and reflection, are related types of repetitive thinking that may be better
captured as subtypes of some larger construct, such as avoidant coping strategies.
Negative Automatic Thoughts Rumination has been compared to negative automatic
thoughts, defined as repetitive thoughts that contain themes of personal loss or failure.
Nolen-Hoeksema contends that rumination is distinct from negative automatic thoughts
in that while negative automatic thoughts are relatively shorthand appraisals of loss
and depression in depression, rumination consists of longer chains of repetitive, recyclic,
negative and self-focused thinking that may occur as a response to initial negative thoughts.
Nolen also suggests that rumination may, in addition to analysis of symptoms, causes,
and consequences, contain negative themes like those in automatic thoughts. Similarly,
Papageorgiou and Wells have provided supports to this conclusion when they found that rumination
can predict depression even when negative cognitions are controlled, suggesting that
these constructs do not wholly overlap and have different predictive value. Despite Nolen-Hoeksema's
argument that rumination and negative automatic thoughts are distinct phenomena, the Response
Style Questionnaire has been criticized for its conceptual overlap with negative automatic
thoughts. See also
Major depressive disorder Worry
Co-rumination Obsessive compulsive disorder
Footnotes
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A. J., N. "An examination of happiness as a buffer of the rumination–adjustment link:
Ethnic differences between European and Asian American students". Asian American Journal
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depressive rumination, anger rumination, and borderline personality features". Personality
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Simonson, J.; Mezulis, A., & Davis, K., N. "Socialized to ruminate? Gender role mediates
the sex difference in rumination for interpersonal events". Journal Of Social And Clinical Psychology
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